Association between adipokines and the development of osteopenic syndrome in end-stage lung disease


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Abstract

AIM: To study of an association between adipokines, nutritional status, and bone mineral density (BMD) in end-stage lung disease (ESLD). /MATERIAL AND METHODS: Forty-seven patients aged 26 to 62 years with ESLD were examined. BMD in the lumbar spine (LII-LIV) and left femoral neck (FN) was estimated using dual-energy X-ray absorptiometry (DXA). The serum levels of adipokines (leptin, adiponectin resistin, tumor necrosis factor-α (TNF-α), and its receptors sTNFR I, II) were determined. A control group consisted of 45 healthy volunteers matched for age and gender /RESULTS: Osteopenic syndrome (T-score <-1 SD) was recorded in 43 (91%) of the 47 examined patients with ESLD. In lung diseases, the concentrations of adiponectin, resistin, TNF-α, and its receptors were higher and the level of leptin was lower than in the control group. There was a positive correlation between the content of leptin (r=0.64, p=0.0002; r=0.52, p=0.009) and a negative correlation between adiponectin (r=-0.54, p=0.009; r=-0.47, p=0.003), TNF-α (r=-0.43, p=0.03; r=-0.41, p=0.04), and BMD in FN and FN LII-LIV. Correlation analysis showed a positive correlation between the level of resistin (r=0.57; p=0.004), sTNFR I (r=0.42; p=0.03), sTNFR II (r=0.44; p=0.04), and BMD in LII-LIV only. The serum leptin level was positively correlated with body mass index (BMI) (r=0.82; p<0.0001) and total fat mass (TFM) (r=0.84; p<0.0001). On the contrary, the level of adiponectin was inversely correlated with BMI (r=-0.68; p<0.001), serum resistin concentration (r=-0.57; p=0.004), sTNFR I (r=-0.58; p=0.007), and sTNFR II (r=-0.53; p=0.006). It was stated that there was a strong inverse correction between the levels of leptin and adiponectin (r=-0.67; p=0.0008) /CONCLUSION: The found associations between adipokines and BMD may suggest that these markers are implicated in the pathogenesis of osteopenic syndrome in ESLD.

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Связь между адипокинами и развитием остеопенического синдрома при терминальной стадии легочной патологии. - Резюме. Цель исследования. Изучить взаимосвязи адипокинов, статуса питания и минеральной плотности костной ткани (МПКТ) при терминальной стадии легочной патологии (ТСЛП). Материалы и методы. Обследовали 47 пациентов с ТСЛП в возрасте от 26 до 62 лет. МПКТ в поясничном отделе позвоночника (LII-LIV) и шейки левой бедренной кости (FN) оценивали с помощью двухэнергетической рентгеновской абсорциометрии (DXA). В сыворотке крови определяли уровень адипокинов (лептина, адипонектина резистина, фактора некроза опухоли-α - TNF-α и его рецепторов sTNFR-I, II). Контрольную группу составили 45 здоровых добровольцев соответствующего пола и возраста. Результаты. Остеопенический синдром (T-критерий <-1 SD) зарегистрирован у 43 (91%) из 47 обследованных больных с ТСЛП. При легочной патологии концентрации адипонектина, резистина, TNF-α и его рецепторов были выше, а уровень лептина ниже, чем в контрольной группе. Выявлены положительная корреляция между содержанием лептина (r=0,64, p=0,0002; r=0,52, p=0,009) и отрицательная - между адипонектином (r=-0,54, p=0,009; r=-0,47, p=0,003), TNF-α (r=-0,43; p=0,03; r=-0,41, p=0,04) и МПКТ в FN и LII-LIV. Корреляционный анализ показал наличие положительной корреляции между уровнем резистина (r=0,57; p=0,004), sTNFR-I (r=0,42; p=0,03) и sTNFR-II (r=0,44; p=0,04) и МПКТ только в LII-LIV. Содержание лептина в сыворотке крови позитивно коррелировало с индексом массы тела - ИМТ (r=0,82; p<0,0001), общей жировой массой - ОЖМ (r=0,84; p<0,0001). Напротив, уровень адипонектина обратно коррелировал с ИМТ (r=-0,68; p<0,001), ОЖМ (r=-0,62; p<0,001), уровнем в сыворотке крови резистина (r=-0,57; p=0,004) и sTNFR-I (r=-0,58; p=0,007) и sTNFR-II (r=-0,53; p=0,006). Констатирована сильная обратная корреляция между уровнями лептина и адипонектина (r=-0,67; p=0,0008). Заключение. Выявленные ассоциации между адипокинами и МПКТ позволяют высказать предположение о роли данных маркеров в патогенезе формирования остеопенического синдрома при ТСЛП.
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